Pneumonia and Influenza

Flu and pneumonia are respiratory illnesses that should not be taken lightly. In the United States, pneumonia and the flu combined are the eighth leading cause of death. Older adults are at greater risk than younger adults for contracting pneumococcal pneumonia, the most common bacterial form of the disease. Taking steps to prevent pneumonia, recognizing the symptoms, and getting early treatment are vital to maintaining good health.

What is pneumonia?

Pneumonia is an inflammation of the lungs—either one or both—caused by an infection. The inflammation makes it difficult for oxygen to reach your blood.

Pneumonia can have more than 30 causes, but the five main culprits are bacteria, viruses, mycoplasma, other germs such as fungi and parasites, and chemicals. The most common form of pneumonia is caused by viruses; half of all pneumonias fall into this category. Bacterial pneumonia can develop after a case of the flu, when your immune system is weak from fighting the flu virus. Bacterial pneumonia is commonly caused by Streptococcus pneumoniae, but in most instances, this form of pneumonia can be prevented with a vaccine.

Pneumonia can be a serious, potentially fatal condition, particularly in the very young and in older adults.

Although most people think of pneumonia as affecting only the lungs, the bacteria that cause pneumococcal pneumonia can attack other parts of the body, according to the National Institute on Aging (NIA). When these bacteria attack the covering of the brain (meninges), they cause meningitis. When they enter the bloodstream, they cause bacteremia or septicemia. They can also cause middle ear and sinus infections, the NIA says.

The pneumococcal bacteria are found in up to 70 percent of healthy people, the NIA says. They are spread from person to person through coughing, sneezing, or close contact. Researchers don't know why the bacteria suddenly invade the lungs to cause illness.

What is influenza?

Influenza—or "the flu"—is a highly contagious respiratory infection caused by a virus. Although the flu usually is mild in children and younger adults, it can cause life-threatening viral pneumonia in older adults, the NIA says. Influenza epidemics such as the one in 1916 (Spanish Flu) have killed millions of people worldwide.

The best medicine

Experts recommend the pneumococcal vaccine for people at high risk for serious problems if they get pneumonia. This includes adults with chronic conditions like asthma, alcoholism, COPD, and diabetes—all of which affect the immune system; residents of nursing homes and long-term care facilities; and people who smoke cigarettes.

The CDC reports that some strains of the bacteria causing pneumococcal pneumonia have become resistant to the drugs used for treatment. This makes prevention through vaccination even more important.

Anyone 6 months or older should receive an annual seasonal flu vaccine. Influenza viruses are constantly changing, so it's important to get a new flu shot each year. It's best to get a flu shot in the fall, before flu season starts, the NIA says. Flu vaccine is generally available from the end of September or early October until the end of the season in January or February.

The CDC recommends that people 65 and older have a second dose of the pneumococcal vaccine if it has been five years since the first dose and if they were younger than 65 when they received it.

These steps can also help prevent pneumonia and the flu:

  • Wash your hands frequently, using soap and water or an alcohol-based cleanser.

  • Don’t smoke.

  • Get adequate sleep, exercise regularly, and eat a nutritious diet.

Know the symptoms

Prevention is the best medicine, but recognizing pneumonia symptoms and getting professional care right away can help people protect their health.

The symptoms of bacterial pneumonia can appear gradually or suddenly:

  • Fever, which can be as high as 102 degrees

  • Shaking chills

  • Sharp chest pain

  • Abdominal pain

  • Profuse sweating, confusion, rapid breathing and pulse rate, shortness of breath, and severe fatigue

  • A cough that produces greenish or rust-colored mucus

  • Worsening of symptoms after a cold or the flu

These are symptoms of viral pneumonia:

  • Initial flulike symptoms: fever, headache, muscle aches, and dry cough

  • Worsening of symptoms after 12 to 36 hours: fever, breathlessness that may become extreme and a more severe dry cough that produces small amounts of mucus

  • A bluish color to the lips; this occurs in some cases

These are symptoms of the flu:

  • Headache

  • Chills

  • Dry cough

  • Muscle aches (myalgia)

  • Fever

  • Stuffy nose

  • Sore throat

The fever usually appears on the second or third day of the flu, according to the National Institute of Allergy and Infectious Diseases. The flu almost never causes stomach or abdominal symptoms.

Get treatment quickly

Early treatment of bacterial pneumonia helps with recovery, so see your health care provider as soon as symptoms appear. If your doctor diagnoses bacterial pneumonia, treatment typically includes antibiotics and possibly other medications to help relieve coughing and chest pain. No treatment usually is given for viral pneumonia, although medication can be taken to relieve symptoms. Early treatment of the flu with antiviral drugs is effective in older adults.


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